Coronary disease & ACSCohort study
Heart Failure Readmission in Patients With ST-Segment Elevation Myocardial Infarction and Active Cancer
- Retrospective cohort study
- nationally linked registry cohort
- multivariable Fine-Gray competing risk models
Authors' conclusion
Cancer patients receive care that differs in important ways from patients without cancer.
Study context
- Population
- STEMI admissions, UK MINAP and HES registries, January 2005–March 2019
- Participants
- 326,551 STEMI indexed admissions
- Exposure
- Active cancer vs no cancer
- Cancern = 7,090
- Outcome
- HF readmission
- Follow-up
- 30 days and 1 year
Main finding
As reported in the abstract
Cancer
3.2%
30 days · 1 year 9.4%
No cancer
2.3%
30 days · 1 year 7.3%
Cancer vs No cancerSubdistribution hazard ratio (95% CI)
30 days, adjusted
1.05(0.86–1.28)
1 year, adjusted
1.03(0.92–1.16)
Observational data: associations, not effects.
Further findings
In-hospital care, cancer vs no cancer
- Admitted under a cardiologist, cancer vs no cancer
- 74.5% vs 81.9%
- Invasive coronary angiography, cancer vs no cancer (P < 0.001)
- 62.2% vs 72.7%
- PCI, cancer vs no cancer
- 58.4% vs. 69.5%
Discharge medications, cancer vs no cancer
- ACEi/ARB, cancer vs no cancer
- 49.5% vs 71.1%
- Beta-blockers, cancer vs no cancer
- 58.4% vs 68.0%
Opportunity-based quality indicator and heart failure (HF) readmission
- Associated with higher rates of HF readmission independent of cancer diagnosis
Original publication
Heart Failure Readmission in Patients With ST-Segment Elevation Myocardial Infarction and Active Cancer. JACC CardioOncol. Published 9 January 2024. doi:10.1016/j.jaccao.2023.10.011
Summarised from the published abstract; every number is checked against it